godfather of surgery

Yang Ping was able to perform such a major surgery as if he were chopping up melons and vegetables.

Forget about pulling out the steel bars so quickly, the second-stage orthopedic surgery was also done at the same time, and even the thoracolumbar fractures were fixed in the first stage.

I can barely accept helping the thoracic department to stop bleeding, but you also help the neurosurgery department to stop bleeding at the base of the skull.

This made Director Xu a little doubtful about life. He wondered whether this was Union Medical College and whether he was a senior emergency surgeon. In front of Professor Yang, he acted like a rookie. As an assistant, the whole operation process was very passive and he was always tired. Follow the pace of surgery.

Director Xu found that he had never been as vulgar as he was today, because he kept saying vulgar words in his heart during the whole operation: Damn it, how could you do this? Could you please slow down a bit? Awesome plus——

Maybe no matter who he is, he is prone to swearing when he is anxious. Normally he is very polite. Director Xu can only comfort himself in this way.

After a big battle, the next operation came to an end. Everyone was not as nervous as before and seemed a lot more relaxed. Although they were very tired after the big battle, they felt infinitely satisfied. As a doctor, nothing is more satisfying than saving the life of a patient. People are satisfied.

"Anesthesiologist, vital signs?" Director Xu's voice was high-pitched now, unlike someone who stayed up all night.

The anesthesiologist's voice also matched Director Xu's: "Heart rate 105 beats/min, respiration 23 breaths/min, blood pressure 95/61mmHg, stable!"

The heart rate is a bit faster, but it doesn't matter. With so much blood loss just now, it is normal for the heart to beat faster in order to compensate. As long as it is not too outrageous, after the patient's hemoglobin returns to normal, the heart rate can naturally drop to less than 100.

The breathing frequency is 23 times/min. This breathing frequency is the frequency of the anesthesia ventilator, not the frequency of the patient's spontaneous breathing, and does not mean much.

The blood pressure is 95/61mmHg. As long as it is not a shock blood pressure, it is already a victory. After losing so much blood, don't expect the blood pressure to be the same as that of a normal person.

"Where's the urine?"

The circulating nurse was putting a wave of urine into the patient's urine bag from under the sterile sheet: "More than 5 ml of urine in 800 hours."

Director Xu was relieved. The urine output was very normal. In medicine, urine output less than 24 ml in 100 hours is called anuria, and urine output less than 24 ml in 400 hours is called oliguria.

Now there are more than 5 milliliters in 800 hours. If you convert it, this kind of urine volume is very reassuring. If there is oliguria or anuria, it means that the body's capacity is insufficient, then there may be shock or acute renal failure, which is a very dangerous sign.

Professor Liang reminded:

"Xiao Yang, take a rest."

Song Yun ran over to help Yang Ping take off his surgical gown.

It was time to take a rest. Yang Ping left the remaining finishing work to several directors. Now that the main steps of the operation have been completed, there is very little active bleeding, only some capillary bleeding, and blood transfusions only need to be followed in time. The patient's life is still somewhat protected for the time being.

As for what will happen after surgery, no one can make an accurate prognosis.

Patients with severe multiple trauma still have many problems to face after surgery, such as postoperative infection. Because stool contaminates the abdominal cavity, the probability of infection is extremely high. Once infected, because the own immunity is low, it can easily lead to infection. out of control.

All the doctor can do is to try to debridement as thoroughly as possible, of which flushing is crucial. Repeated flushing with large amounts of normal saline can maintain cleanliness during the operation and dilute the bacteria to an infinitely low concentration. Antibiotics can also be used after the operation. , the use of this antibiotic is no longer preventive, but therapeutic.

Problems patients also face after surgery are dangerous complications such as fat embolism, systemic inflammatory response syndrome, and multiple organ failure, each of which can be fatal.

After taking off the surgery, Yang Ping felt that his clothes were soaked. He had just undergone such a big surgery, and there were so many movements on his hands. He had to be highly concentrated, multi-tasked, and had many parts to take care of, which naturally consumed his energy.

Professor Liang stood in front of the reading light and waved, and Yang Ping immediately went over. It turned out that the old academician had a few things that he didn't quite understand and needed to discuss with Yang Ping, such as how to become so proficient in anatomy. Every time he saw Yang Ping performing surgery, It feels like he can dissect the human body with his eyes closed.

Other doctors also gathered around Yang Ping, wanting to hear what he had to say.

The surgery just now was like a performance of emergency trauma surgery, allowing all doctors to see the true level of a king. The superb surgical skills involved are by no means as simple as the speed of surgery. They include quick judgment of the injury and quick planning of the surgery, combined with preoperative examination and injury mechanism to determine the location and extent of the injury, and then combined with one's skilled anatomy knowledge to accurately perform the surgery. Determine which blood vessels and organs are damaged along the path of the steel bar.

After an operation, several hours passed, but everyone was still very enthusiastic and had no sleepiness. They had no idea that they had stayed up all night until early morning. Some doctors even came over and asked Yang Ping why the operation was done like this, hoping to learn more. .

There are also some doctors who simply come here to get close, join in the fun, and become familiar with each other. Yang Ping is undoubtedly the god of these young doctors.

In particular, the training doctors have helped each other secretly take photos, and then take the photos back to their own hospitals. They can also say that they have had surgery with Professor Yang. If Professor Yang becomes an academician one day, they can also frame the photos. , placed on the desk for display.

Director Long and Director Wen now feel that this meal was well worth the price. Yang Ping not only helped with several surgeries, but also helped with emergency surgeries in the middle of the night. The key was that the young doctor gained a lot of insights.

They couldn't help but sigh, it would be great if there was a doctor like this in their department, or if the academician had the vision to recruit such a powerful young man.

Director Xu finished on the stage. Today's operation was a lesson for him. Whether it was the speed of the operation, the overall planning of the operation, or the grasp of details, it was almost impeccable, and it was the ceiling level of emergency surgery.

Of course, in the past, Director Xu did not realize how high the ceiling of emergency surgery was. He would often feel that he could reach it at his fingertips, and even feel that he had touched the ceiling when he was full of energy. Today, it seems that the ceiling is higher than imagined.

The firefighter waited outside the operating room for a long time. There was no movement inside, and he did not dare to come in. The doctor accompanying him had also come in to watch the operation.

So he knocked on the door and asked, "Do you still need my help?"

Only then did Director Xu remember that there was a firefighter waiting outside with cutting tools, and he immediately said, "Thank you for your hard work." Then he asked a doctor to send the firefighter out.

The firefighters packed up their belongings and left the operating room accompanied by the doctor, but none of the doctors in the operating room left. Even though the operation had come to an end, they still gathered in the operating room and were unwilling to leave for a long time. "When I did the anterior approach to the thoracolumbar burst fracture, I saw that there was no bleeding? Is there any special method?"

Song Yun just paid special attention to orthopedic surgery, especially spinal surgery. Just now, when Yang Ping performed a thoracolumbar burst fracture and removed the vertebral body, he saw very little bleeding. Conventional vertebral body removal will cause a lot of bleeding, which sometimes affects blood pressure.

"Except for high-level hemostasis, the only martial arts in the world that is fast is unbreakable." Professor Liang answered this question for Yang Ping.

In fact, this is the case. Although the operation is not just for the sake of speed, but on the premise of ensuring the quality of the operation, the operation time should be shortened as much as possible, so that the bleeding will be the least and the impact on the patient will be smaller.

"How can we increase the speed of surgery?" a doctor asked.

Professor Liang once again answered on behalf of Yang Ping: "Practice makes perfect! You need to be familiar with anatomy knowledge, basic surgical skills, and surgical operations."

With such a lesson-like answer, Professor Liang felt that it would be better for him to answer it for Yang Ping, so he took this opportunity to tell the young doctors the importance of being "skilled".

There is no limit to proficiency. For example, in anatomy, you need to review it constantly and over and over again, so that the entire anatomy book and the entire set of anatomy diagrams are rotten in your mind.

In fact, Yang Ping did this. The difference was that he had a lot of time and opportunities to learn anatomy and dissect experimental subjects in the system space.

His proficient surgical skills were also acquired through devilish training in the system space. Every bit of progress was the result of huge efforts. He trained over and over again in the closed, lonely, and monotonous system space, relying on the support of interest. .

"That's true. Whether it's theory or practice, let it be cooked in your mind. When it's cooked, it will be integrated with you, and you will get what you want as soon as you take action. It's like typing, as training When you are extremely familiar with it, both your brain and muscles have already formed a memory. When a word pops up, you don’t have to think about it at all, and your hands will directly touch the key you want. "

Yang Ping also felt this and told everyone his experience. Although everyone does not have as much time and opportunities as he does, they can always be as proficient as possible within their own capabilities.

"Look, this steel bar penetrates from the perineum. We look at its path on the CT scan and immediately combine it with the anatomy to find out where it passes, what organs these places are, what tissues they belong to, and what blood vessels and nerves pass through them. If these What happens with structural damage.”

"Similarly, when you stop bleeding, when the suction device draws away the blood and the blood comes out again, you need to capture where it came from, what blood vessels are here, the typical thickness of the blood vessels, and what happens after they break."

"Master its rhythm, everything has a rhythm, surgery has a rhythm, illness and injury also have a rhythm."

In fact, Yang Ping doesn't know whether he is right or not, but he is willing to share some of his so-called experiences with everyone, and he is willing to share his new ideas and new techniques with everyone. He always believes that no matter how great a doctor is, he can only have one. Hands, only by popularizing medical skills can it benefit the public.

These doctors were not just young doctors, but also Director Long and Director Wen. They listened carefully to Yang Ping's sharing of his experiences.

"For mutated blood vessels, such as the blood supply blood vessels of the pancreas, which are very unstable, how can I find them quickly and safely, especially when there is rupture and bleeding, or when undergoing tumor surgery, how can I quickly identify them as tumors? blood vessels or blood vessels of an organ?”

Director Long asked questions like a student. At this time, he already felt like he was back in his youth, when everyone discussed surgery together without any scruples.

"In fact, the best way to find and distinguish mutated blood vessels is the tracking method, which is what we often call following the clues. Any blood vessel has a source and a destination. If we grab any one and touch it quickly, we will definitely find the other one. If one end and both ends are clear, the identity of the natural blood vessel will be clear.”

''As for how to judge the location when a mutated blood vessel ruptures, blood vessels of different locations and calibers bleed differently. They have subtle differences. Moreover, we have pre-operative images, which is equivalent to obtaining the patient's anatomical data of the mutated blood vessel in advance. , mutation is not unfamiliar. "

"For example, the bleeding blood vessel behind the pancreas just now, you see, it is very clear on the CT, but our observation of the CT is not so subtle, so we need to improve the accuracy when reading the images."

Yang Ping pointed to the blood vessels on the film and said.

Everyone was chatting here, and the operation was about to end over there. When the operation was over, Song Yun looked at the time, and it was already past six in the morning. Everyone finally dispersed, and it was an hour before they could sleep.

Yang Ping, Song Yun, Kong Weiquan, and other young doctors in the ward usually live in the duty room.

But everyone still wants to sleep. Their minds are filled with the scenes of surgery. They use their fingers to precisely control instruments, multi-tasking, and precise and fast hemostasis techniques, all of which demonstrate extremely superb surgical art.

The treatment given to Yang Ping by Xiehe was quite good. He was given 45 beds and all the benefits were at the director level, including his own independent duty room for rest.

The next day, Yang Ping had another day of surgery. The whole day, Yang Ping's operating room was full of people, all coming to observe the operation.

Probably due to the sensational effect of last night's rescue operation, doctors from almost every department of surgery came to visit, coming and going, many of them strangers, and they all came to see Yang Ping's surgery.

Kong Weiquan said that with so many people coming and going, it seriously affected the order of the surgery, and it was impossible to charge tickets to see if they would come.

Song Yun felt that it was definitely inappropriate to stop visitors, but it was still necessary to control the flow of people and ensure normal surgical order, so he sent two doctors to act as doormen to guard the door and control the number and time of people coming in. Visitors in the front left, and those behind Allowed to come in.

Even so, these doctors would rather wait in line to observe Yang Ping's surgery. Throughout the whole day, Yang Ping performed surgery under the watch of doctors coming and going from Xiehe.

In the evening, Director Long entertained everyone again, but the night was uneventful and there was no more emergency surgery.

Yang Ping has completed his teaching duties in Xiehe for several days. Before going to the airport, Yang Ping also checked the wards and went to the ICU to see babies undergoing coronary artery bypass grafting, patients with pancreatic cancer, and injured people who fell from heights. They were all very stable after surgery. .

PS: I’m really sorry, I’m quite busy today and haven’t posted much, thank you all!